The Emerging Role of Robotics in Pelvic Exenteration Surgery for Locally Advanced Rectal Cancer: A Narrative Review

Pelvic exenteration surgery for locally advanced rectal cancers is a complex and extensive multivisceral operation, which is associated with high perioperative morbidity and mortality rates. Significant technical challenges may arise due to inadequate access, visualisation, and characterisation of tissue planes and critical structures in the spatially constrained pelvis. Over the last two decades, robotic-assisted technologies have facilitated substantial advancements in the minimally invasive approach to total mesorectal excision (TME) for rectal cancers. Here, we review the emerging experience and evidence of robotic assistance in beyond TME multivisceral pelvic exenteration for locally advanced rectal cancers where heightened operative challenges and cumbersome ergonomics are likely to be encountered.

Automated summary

Pelvic exenteration surgery for locally advanced rectal cancers is a complex and extensive multivisceral operation with high perioperative morbidity and mortality rates. Robotic-assisted technologies have significantly advanced the minimally invasive approach to total mesorectal excision for rectal cancers in the past two decades, providing emerging experience and evidence in addressing operative challenges and ergonomic issues in beyond TME multivisceral pelvic exenteration for locally advanced rectal cancers.